Clinical implications of serum adiponectin on progression of atrial fibrillation

BACKGROUND: The association between circulating adiponectin levels and atrial fibrillation (AF) is uncertain. We, therefore, investigated whether an increased serum adiponectin level is implicated in the long-term recurrence of AF after ablation therapy. METHODS: Our study included 100 consecutive patients (88 men; median age, 57.9±10.9 years) who underwent catheter ablation for AF at our hospital between 2011 and 2013. The adiponectin and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were measured before ablation and compared between those in whom AF recurred and those in whom AF did not recur. RESULTS: Elevation in adiponectin levels was significantly associated with female sex, non-paroxysmal AF, heart failure, higher NT-proBNP and matrix metallo-proteinase-2 levels, and lower body mass index. After a stepwise adjustment for any potential confounding variables, the adiponectin levels remained significantly associated with female sex (beta=0.2601, P=0.0041), non-paroxysmal AF (beta=0.2708, P=0.0080), and higher NT-proBNP levels (beta=0.2536, P= 0.0138). During the median follow-up period of 26.2 months, AF recurred in 48 of the 100 patients. Stepwise multivariate adjustment showed that an increased log-transformed NT-proBNP (Hazard ratio [HR], 2.18; 95% confidence interval [CI] 1.25–4.00; P=0.0055), longer duration of AF (HR, 1.87; 95%CI 1.01–3.76; P=0.0465), and decreased left ventricular ejection fraction (HR, 0.96; 95%CI 0.93–0.99; P=0.0391) were independent predictors of recurrent AF after catheter ablation, but adiponectin was not. CONCLUSIONS: Our data indicated that adiponectin was partially responsible for progression of AF, but the correlation between adiponectin levels and AF recurrence was not significant.